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Request for Extension to Comply (Building Inspections)
This form has been modified since it was saved. Please review all fields before submitting.
Please complete the form with all necessary information. Forms must be filled out completely and accurately to be accepted.
Applicant/Property Owner's Name
Address of Case/Violation
Applicant/Owner's Primary Phone
When reviewing this request, consideration will be given to all pertinent surrounding circumstances including the reasons for the delay, plans for completion, and the amount of progress made to date.
Reason(s) for Extension Request
Identify reason(s) compliance has not been achieved within the required time frame.
Correction(s) made/Plans for Completion
Identify what has been corrected and current plans for completion and code compliance.
Attach additional information and/or photos, if applicable
What is the anticipated completion date?
Please Click the "Submit" button at the bottom of the page. Thank you.
If your request is granted and compliance is not achieved by the revised compliance date, or an additional extension has not been granted, fines and/or additional penalties may continue to accrue as stated in the original Rule to Show Cause hearing decision, which can include referring this case to the County Attorney for possible legal action, and/or taking remedial action to resolve the violation(s).
This Section is for County Use Only - Please Do Not Fill Out
◊ Extension Granted
◊ Request Denied
Supervisor Signature:_____________________________________ Date:_____________________
Building Inspector: _______________________________________ Date:_____________________
PLEASE NOTE: Submitting this form constitutes your electronic signature and certifies that you are the owner of the property or its legal or designated representative.
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